Breastfeeding after a C-Section

By Krista Gray, IBCLC. Last updated February 8, 2013.

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Whether you had a planned cesarean section or labor didn’t go as you’d hoped and you ended up having an unplanned one, breastfeeding following this type of delivery is still completely possible.  In fact, being able to nurse your baby will not only establish a strong bond together but can help overcome any guilt or regret some moms feel after an unplanned cesarean section.

How long must I wait following a Cesarean section to begin breastfeeding?

Physiologically, you do not need to wait to hold or breastfeed your baby, although you will need assistance.  But, each hospital has its own set of regulations regarding this.  If you have a planned C-section, you can discuss their policy and possibly negotiate this in advance.  Hospitals typically do not encourage rooming-in for the baby immediately following a cesarean but when a new mom has another person to help, keeping the baby in the room with her at the hospital is very doable.  This can further aid breastfeeding: mom is able to watch early feeding cues the baby gives and nurse regularly; there is less chance that baby will be given formula in an attempt to “allow the mother to rest;” and skin-to-skin time will be easier and more frequent as mom and baby are near one another without interruption.

What if my hospital is not supportive of nursing my baby during recovery?

If your hospital will not allow you to nurse your baby during recovery, you could plan to have your baby in skin-to-skin time with his father and then nurse/hold baby skin-to-skin immediately following recovery.  While some hospitals are beginning to change their policies regarding this and allowing moms to hold their babies during recovery, others still do not.  Having another adult to help support the mother following surgery is important.  Whether you are holding your baby during recovery or afterwards, your partner should not only help to hold or stabilize the baby immediately following the birth, during skin-to-skin time, and/or while you are breastfeeding, but he can also help with diaper changes and bringing baby to mom so she doesn’t have to move as much following surgery.

How do I begin breastfeeding after a Cesarean section?

The single most important factor to getting breastfeeding off to a good start is skin-to-skin contact immediately following birth.  While most women who have a C-section do not have immediate skin-to-skin contact, there are maternity units that are more and more supportive as they begin to understand its importance to breastfeeding.  If this is not the case with your birthing facility, having skin-to-skin contact as soon as possible after the birth, for as long as possible, is optimal.  This not only encourages bonding and maternal and baby health benefits, but it helps a mother’s milk production. In the first few days following birth, spending as much time cuddling your baby, especially skin-to-skin, and nursing as often as your baby wants are the most effective things you can do to get breastfeeding off to a strong start.1

Does having a cesarean birth delay my milk coming in?

No, a C-section in and of itself does not delay a mother’s milk.  Actually, hormones associated with the removal of the placenta trigger breast milk production and this occurs with a surgical as well as vaginal birth.  When the placenta is delivered, there is a sharp drop in progesterone, which is what holds milk production in check during pregnancy.  But while a C-section doesn’t delay milk, stress associated with the birth experience can.  The more stressful the birth experience is for a mother, the greater the chance of her milk coming in more slowly.2  Both an emergency C-section and instrumental vaginal delivery may be more stressful than a planned cesarean.  However, even the most stressful birth experience does not have to be detrimental to breastfeeding. (You can read about my emergency C-section in Egypt here.)

Are pain medication and/or anesthesia contraindicated with breastfeeding?

No.  All types of labor and delivery pain medications are compatible with breastfeeding.  Mothers do not need to wait a certain amount of time, or discard any of their precious colostrum because of a medicated C-section delivery.  However, babies born by cesarean are likely to feel the effects of the pain medications the mother had during labor.  Many times this leads to a sleepier baby who is harder to arouse to nurse, and/or a baby who has a harder time latching and suckling.  It is important to make sure to rouse a sleepy baby to nurse frequently – at least 8-12 times in a 24 hour period – as a mother’s body is getting the message to make plenty of milk for her new baby.

What breastfeeding positions are most comfortable following surgery?

Following a C-section the mother usually experiences quite a bit of pain, especially when moving around.  This can make nursing challenging.  There are many positions that support breastfeeding as well as protecting the mother’s incision.  Many moms find the “football” hold to be effective.  Propping up pillows around the mother so that she is comfortable, she can then sit up or recline while holding her baby’s body on her side while she nurses.  If it is more comfortable for the mother to lie down, she can nurse her baby on her side while her baby is lying on the bed tucked in next to her.  Nursing while reclining, with baby wrapped around mom’s chest and feet tucked in on her side, is another possible position.  There is no one right method, though.  The most important thing is that you are comfortable, baby isn’t putting undue pressure on your incision, and your baby is able to latch and remove milk effectively.

You may also be interested in reading about my unplanned, emergency C-Section in Egypt.

Show 2 footnotes

  1. Hung, K. et al.  Early skin-to-skin after cesarean to improve breastfeeding.  American Journal of Maternal/Child Nursing 2011; 36:318-324.
  2. Grajeda R, Perez-Escamilla R. (2002) Stress during labor and delivery is associated with delayed onset of lactation among urban Guatemalan women Journal of Nutrition 132(10):3055-60